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General NPI Number Information
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NPI Number | 1154039717
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Entity Type | Individual
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Provider Name | ALYSSA YNIGUEZ OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 544 LIPPINCOTT DR
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City | MARLTON
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State | NJ
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Zip | 08053-4806
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Country | US
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Telephone | 856-810-5777
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BARCLAY WALK
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2108
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Country | US
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Telephone | 856-701-9910
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR01090800
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License Number State | NJ
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